Dural arteriovenous fistula after cerebral sinus thrombosis: a case study of serial venous transcranial color-coded sonography.

Abstract

Dural sinus thrombosis has been proposed as the primary event in the formation of a dural arteriovenous fistula (DAVF). 1 - 4 However, the temporal course of development of a DAVF after cerebral sinus thrombosis has rarely been shown clinically. Venous angiography is a sensitive method for evaluating sinus thrombosis. 5 However, the invasiveness of venous angiography limits its value in the follow-up of patients. Venous transcranial color-coded sonography (TCCS) has been used to detect changes in venous flow in patients with sinus thrombosis. 6 - 8 Venous TCCS may serve as a useful, noninvasive, cost-effective examination technique for the follow-up of patients with cerebral sinus thrombosis. 6 , 7 , 9 It also provides information on venous hemodynamics related to outcome, 9 but clinical experience is limited. We report a case of an acquired DAVF after intrasinus thrombolysis for cerebral venous sinus thrombosis. Venous TCCS showed sequential changes in venous blood flow, indicating venous sinus hypertension and the occurrence of an abnormal arteriovenous connection.